Application For Pet Adoptions Please fill out this form completely; failure to answer one or more questions may result in your application being rejected. Completion of this application does not guarantee adoption of a Paws For Life K9 Rescue dog. Name of Desired DogYour Name* First Last Your email* Daytime phone*Evening phoneYour Occupation*Partner/Spouse's Name First Last Partner/Spouse's OccupationName/ Ages of Children, if anyAny other occupants in your home?Your home address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please indicate your age group*18-2122-2627-3233-4546-5556-7071+Type of dwelling*HouseCondoApartmentDo you rent or own?*RentOwnWhat are your primary reasons for wanting a dog?* Companion for you For your kids Gift For other pet Watchdog Other What is your other reason?If you have children, please describe their previous experience with dogs.Do you have a pet now?*YesNoHow many pets do you currently have?*Type of pets (if dog, list breed)*What are the ages and genders of your current pets?*Do you have other pets?*YesNoPlease list your other pets*How long have you owned your other pets?*Where did you get your other pets?*Are your pet/s spayed or neutered*YesNoWhich pet/s are not spayed or neutered?*Have you ever had to surrender an animal to a shelter or rescue group?*YesNoPlease explain the circumstances*Is there anybody home during the day?*YesNoAbout how many hours will the dog be left alone?*Where will the dog stay when he/she is home alone? (please be as specific as possible; e.g. run of the house, a specific room, a crate, etc.)*Where will the dog sleep at night (be specific)?*What outside areas are available to the dog? (select all that apply)* Fenced yard Enclosed patio Garage Dog house Unfenced common area Other Please describe the other area(s)*Please describe the type of fencing around the yard. (Chain link, wood, block wall, etc.)*What the highest point of the fence (measured in feet)?*What the lowest point of the fence (measured in feet)?*Please enter a number from 0 to 12.What the lowest point of the fence (measured in feet)?*I promise to inspect my fences thoroughly before the home visit and make necessary repairs for the safety and well-being of our new pet.*YesNoDo you have a swimming pool?*YesNoIs your swimming poll surrounded by a gate?*YesNoWho has access to your yard? (Check all that apply)* No one has access Family members Gardener Pool man Utility workers Neighbor Other Please describe any others who have access to your property*Your preferred level of exercise with your dog*Couch potatoShort walksVigorous walksHike or jog regularlyWould your dog wear a collar with an ID tag?*YesNoWould you allow your dog to wear a permanent Paws For Life ID tag?*YesNoHow would you rate your level of dog owning experience?*First time ownerBeginnerIntermediateAdvancedOtherPlease describe your dog owning experience.*What, if any, behavioral issues have you dealt with in the past? (Check all that apply)* Dog aggression People aggression Leash aggression House breaking Separation anxiety Escaping Fear aggression None of the above Would you be willing to sign your new dog up for obedience classes at your own expense?*YesNoPets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, shelter, and exercise for your new pet?*YesNoWhat would happen to your pets if you moved locally, out of state, or out of the country?*Which of the following reasons might prompt you to give up your dog? (Check all that apply)* Excessive barking Biting Digging Moving Divorce Baby Illness Not getting along with other pet(s) Poor watchdog Destructive chewing Financial problems Occasional accidents indoors Growling at guests Excessive vet bills Shedding Allergies New spouse/partner doesn't like dogs Aggressive on leasht None of the above (Add a comment) Your comments*Please list pets you have owned since you have been an adult and the length of ownership; if they are no longer with you, please provide an explanation (died, gave away, etc.). Please list the type and breed/breed mix of each pet.*Please read and acknowledge each statement below:* I understand that a home visit is required prior to final placement. I understand that a home visit does not guarantee placement. Adopters become a part of our Paws for Life K9 Rescue community. Here is what we offer our adopters and their new animal companion: 24/7 emergency answering service Hands on Follow Up Program Free monthly individual training consults I CAN give a tax-deductible charitable adoption contribution of at least $300 to help rescue, provide medical care, spay, and neuter, board and place other abandoned dogs. (Inability to make an adoption donation does not disqualify an applicant fromconsideration). I understand that this adoption donation or contribution is a gift freely given, not a purchase price for a dog:*YesNoPaws For Life K9 Rescue reserves the right to refuse adoption to any applicant for any reason. This questionnaire becomes part of our contract.*I agree.I don't agree.How did you find out about Paws For Life K9 Rescue?*Walk inReferred by someonePaws For Life K9 websitePetfinder/Adopt A PetFacebookWho referred you to Paws For Life K9 Rescue?Monthly Donation ProgramJust as little as $5 per month helps Paws For Life K9 Rescue save more animals. Check here if you would like to join the other monthly donors and sign up today. Check here if you would like to be signed up on our email newsletters. Please provide the email address for which you would like to receive our newsletters. This iframe contains the logic required to handle Ajax powered Gravity Forms.